Provider Demographics
NPI:1336464650
Name:MATZKIN, CAROLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MATZKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 CEDAR LN
Mailing Address - Street 2:APT 1
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4301
Mailing Address - Country:US
Mailing Address - Phone:201-692-3927
Mailing Address - Fax:
Practice Address - Street 1:165 CEDAR LN
Practice Address - Street 2:APT 1
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4301
Practice Address - Country:US
Practice Address - Phone:201-692-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013396001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical